- Kaiser Health News (Aug. 20): Wrestling with a Texas county's mental health system
- Houston Public Media (Aug. 21): Pilot jail diversion program for mentally ill
Still, usually when I hear someone tout their work as a model, I think: That's great, I hope it's true the brave new world begins at your doorstep and this or that local program changes how everybody does everything. OTOH, I'm generally more comforted to hear about tax dollars spent following models that work than attempting to forge them, which is a dicier play.
Our fundamental problem is that Texas spends too little on behavioral health care (49th among states in per capita spending) and too much of what care is delivered happens through the criminal justice system. So diversion programs are the right way to go. Indeed, when one watches the massive, pointless, knee jerk spending at the border that accomplishes nothing, it's hard not to think how much good that money would have done expanding these sorts of mental health diversion programs to other jurisdictions. These programs actually work, are cost effective, and directly make the public safer in the places where most of them live. It'd be difficult to make similar claims about Texas' border surge with a straight face.
If the federal government would do their damn job then that would get us half way there.
ReplyDeleteI say fund mental health and secure the border.
ReplyDelete11:06......+10....otherwise we'll soon be a dead broke country and/or the wicked ones who carry big bad bombs will just glide in and place their wares and stand back and laugh.
DeleteYour main premise is correct: Money is better spent on mental health treatment for persons in the United States rather than efforts to keep others out. However, the difference between San Antonio and Houston is in public relations. Houston diverts far more persons from jail directly to mental health treatment than San Antonio. Neither city can legitimately brag about their models, but San Antonio seems happy to do so anyway since NPR accepts their claims. Simple math will tell you they could not possibly have saved $50M in five years.
ReplyDeleteIt seems if you want to provide mental health care to the neediest Texans, you'll do well to treat prisoners first, especially when so many Black Texans are to be found in prisons.
ReplyDeleteThe money spent on the border should be coming directly out of Perry's campaign contribution funds. After all, the only reason for doing it was to garner publicity for his presidential aspirations.
ReplyDeleteTrigger: That's a thought.
ReplyDeleteRe: "I say fund mental health and secure the border."
ReplyDeleteThough grammatically correct, as a practical matter this is a sentence fragment. It's not a complete thought unless it concludes, "and raise taxes" or else, "and cut funding from programs X, Y, and Z to pay for it." Pick one.
Cut programs X,Y,Z.
DeleteCut programs X,Y,Z and illegals will quit coming across the border for a free ride on uncle sam.
ReplyDeleteThe money provided to mental health practitioners after the last legislative session is already being spent unwisely. Mental health clinics are hiring people, but they are doing nothing. There are visions of mental health courts but no judges who want to be part of it. The Judicial Branch doesn't want to be told by the Legislative Branch how to run their courtrooms. A case manager from a Local Mental Health Authority has little to no clout in a courtroom or before a commissioner's court simply because they aren't lawyers and aren't taken seriously. Not to mention they are clueless as to how to navigate the system.
ReplyDeleteYes, way too many mentally ill people are incarcerated and yes, the race of those incarcerated is disproportionate to those not in jail; but it has always been that way.
Not until decision makers begin to make decisions based on scientific research and empirical data instead of what feels good or what their value system tells them or what they think the average voter wants will there be a difference with social services for the mentally ill.
The mentally ill will never get the services they deserve; just like so many other needy persons. Those providing the service will never make a career out of serving the mentally ill. There just is not enough money involved. The salaries for the case managers is dismal and the legislature changes it mind depending on which way the wind is blowing with these types of issues.
Just like prison substance abuse treatment from the Ann Richards era, the efforts towards the improvement of mental health will go away.
Yes, in 2005 extra diversion funds were provided for the substance abusing population, and it has made some difference, but lasting difference is unlikely unless funding is increased for the agencies providing the services to these populations.
I worked in community supervision for 29 years. 99% of budgets r salary. The judiciary r always on different pages and the DAs r blow hards. Looking back..millions and millions were always tossed at the problems with some results but not enough to measure up to the monies spent. Mental Health caseloads r xllent ideas but it takes a fine tuned team to accomplish it. There isn't much fine tuning in community supervision. I will take reducing X..Y..Z as mentioned above and secure the frigging border.
ReplyDeleteNow, those of you who said "cut programs X, Y, and Z" [drum roll] ... name the programs.
ReplyDeleteOf 20 years of management in community supervision and after attending countless hours of management training from private sources, the former Texas Commission on Human Rights, CJAD, TPA, yadayada, we eventually learned that 90% of your management time was dealing with negative employee issues. I believe one could go through all the state offices and trim 15% of all positions, concentrating on those who do not produce and sit around and surf the web and watch the clock tick to 5:00 PM. There are so many employees that it is almost impossible to find a parking space near the capital area. And that is just Austin. After trimming the deadbeats the coffers would swell with extra billions to spend wisely. This will never happen. You mentioned the X,Y,Z factor. If I took the time to look at a list of all state agencies it would be simple to trim the fat. Of course this is contrary to the liberal thinking of "I'm owed that job" regardless of the quality of work. I say secure the border or the old saying will come up in the very near future "pay me now or pay me later".
ReplyDeleteDon't tell me it would be simple, 12:29, please name the specific agencies and programs you would cut.
ReplyDeleteGRITS: 10% staffing decrease across the board. Except prison guards. The following agencies did nothing , nada, zilch for our offenders; Tex Rehabilitation Commission; Texas Employment Commission; and close all private jails and prisons....to name a few. TRC, TEC, private corrections should be totally eliminated. There was no point in even referring offenders to those if the answer was they don't qualify. TEC would just stick them in front of computer monitors with no real casework. Private prisons are just living off the fat of local governments and the state. TXDOT should be downsized to ONLY qualified, expert engineers and job bid managers since TXDOT contracts most of the work anyway. State BAR: what do they ever do but lightly sanction runaway disreputable attorneys. 10% STAFF DECREASE ACROSS THE BOARD for all state agencies. More indians doing the actual work instead of more supervisors and chiefs who no longer involve themselves with hands on street supervision.
ReplyDeleteSecure the Border should not be political but a safety and cost reality program.
Grits: thats just brief. Why should trimming fat, decreasing beaucracy, and holding employees accountable be so difficult?
ReplyDeleteShow up at an Appropriations hearing, 7:44, make those same suggestions, and find out why it's so difficult. I know you think you're serious, but it's not a serious suggestion. You'd probably be first in line to complain when those government agencies didn't provide you the services to which you think you're entitled. (10% cut at the driver license bureau, anyone? I love long lines.)
ReplyDeleteIf securing the border were a "safety and cost reality" program we would spend no money at all on a surge. Crime rates on the border are lower than in the rest of the state and neither DPS nor the Guard can help with the crisis over the children. It's wasted money with no real safety benefit whatsoever - a martial response to a humanitarian crisis. Wrong tool for the job.
GRITS what programs are you willing to cut in order to keep the borders open with millions of illegals coming across? Surely you aren't arrogant enough to suggest that these numbers won't significantly increase the cost of subsidized income, medical treatment costs passed to taxpayers, increased cost to education system because "it is inhumane to force people to learn English as part of the right to live in America."
ReplyDeleteNot to mention the threat to our security from those of foreign lands with plastic explosives shoved up their ass. GRItS: U mean the only rational response is I have to wait in line.hmmmm. I am serious the question is r u?
DeleteI think im beginning to realize that spending public money is not a problem for grits even if it adds to state bloated programs and frivilous crap. 15% cut across the board is only a pipe dream for those who believe in the almighty beaucracy. U damn right I'm serious and I have made enough of thise wasted trips to austin to last a lifetime.
DeleteNot the case, 10:20, I just know from actually vetting the state appropriations bill, as opposed to yapping about it anonymously in the comments, that there's a lot less "fat" in Texas' budget than you portray and most of what government pays for actually does things people expect of it. Further, what fat exists has special interests attached to it which are more politically powerful than any budget-cutting reformer.
ReplyDeleteThere are programs I'm willing to cut to fund mental health - I think we could easily adjust sentencing to close several more prisons, for example - but not for some phony border security racket. That's a federal function. Besides, across-the-board cuts are not real suggestions if you don't acknowledge that the government must therefore deliver fewer services. There's no such thing as a free lunch.
Finally, you claim you're asking a serious question @9:56 but to believe that you'd have to show me your source on "those of foreign lands with plastic explosives shoved up their ass." They've found a lot of those on the Texas border, have they?
Every county department and state offices offer budget requests that include increases in staff and/equipment. Ur naive to think that most or all local and state offices dont have a 10-15% number of staff who r not productive enough to retain. Ur stance on this suggests ur lack of internal office management or just a philosophical commitment. We shall see if we have future attacks on our homeland. I guess u then will be beating ur chest in grief for those lost because of the lack of a real border policy. Probably not. I named programs that essentially exist in name only but u have to be right because ur a liberal blogger...later alligator since I can listen to ur reasoning all day long on MSNBC.
ReplyDelete@1:50, you're naive if you think that cuts at the Legislature could ever successfully target only unproductive workers. Only someone ignorant of the appropriations process would suggest it's possible. Sorry if saying so offends you.
ReplyDeleteIf you don't mind ignoring math/reality, your plan works fine. I thought you were pretending to offer real-world suggestions - across-the-board cuts ain't that.
Typical response when ur wrong and it's ur BLOG..see ya
ReplyDeleteThanks for constantly begging us to open the border. Oh wait, it's already open.
ReplyDelete+10
DeleteBy "typical" 2:39 I assume you mean demanding facts to back up unsubstantiated assertions or requiring political assessments to be realistic, avoiding pretend solutions and wishful thinking?
ReplyDeleteYou're welcome to read what I write here or not; it's done for me, not you. By all means, please go away.
@4:35, please point to where I've been "begging us to open the border." Actually the things I've proposed - like hiring more immigration judges, for example, and following existing GW Bush-era law to place kids with their family while they wait - would do more to alleviate the border crisis than any additional number of troopers or National Guard on the border could ever do.
I'm for some version of comprehensive immigration reform. Anyone who thinks we're going to deport 11 million people - a forced migration rivaled in history only by the India-Pakistan split and the Soviet transmigration under Stalin - is a fantasist and/or a nutjob. Our economy couldn't take it and our political system wouldn't tolerate the human rights abuses required to undertake the job. I'm sorry if a reality-based view offends your sensibilities, but reality will continue to exist long after your ideological predilections fade.
We can't stop illegal border crossings because if we did, Republican businessmen would have to pay their employees the paltry minimum wage instead of paying illegals $2 an hour. It's the free enterprise system. Employers seek to pay the lowest wages possible in order to maximize profits. Why do you think they ship jobs overseas where many workers make less than $1 an hour?
ReplyDelete